• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

EM with 25 and 31231

A

awillis52

Guest
Messages
6
Bundling tool shows 99214 bundles with 31231. Is it appropriate to add 25 modifier?
 
Yes, you can use -25. However, you need to make sure that you can show Significant, separately identifiable E/M in order to use. Remember, If a code has a global period there is already some reimbursement for E/M built into the code.

The way I look at it is, if a patient walked into the office you are not going to just put a scope up their nose. There has to be some E/M to make sure you actually need a scope and to make sure it's appropriate. If the E/M is outside of what is needed to do the scope you should be OK to use -25. With that said, you'll still need to show medical necessity for the extra E/M and you'll need to "carve out" the E/M for the scope to bill the appropriate E/M Level.
 
Last edited:
You must log in or register to reply here.
Top